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Intravenous caffeine citrate vs. magnesium sulfate for reducing pain in patients with acute migraine headache; a prospective quasi-experimental study

  • Baratloo, Alireza;Mirbaha, Sahar;Kasmaei, Hossein Delavar;Payandemehr, Pooya;Elmaraezy, Ahmed;Negida, Ahmed
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.176-182
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    • 2017
  • Background: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. Methods: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. Results: In total, 70 patients (35 patients in each group) with the mean age of $33.1{\pm}11.3years$ were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). Conclusions: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.

An Application of the Inventory Models to the Intravenous Fluids Subsystem

  • Kim, Young-Min
    • Journal of Korean Institute of Industrial Engineers
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    • v.1 no.2
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    • pp.57-64
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    • 1975
  • Life and death often depend upon the efficiency of the hospital operations. By applying the inventory models to the Intravenous fluids subsystem, the Intravenous finds inventory operation can be systemized and made to run with less management effort and with far greater precision. And most important of all, this more precise form of control can help assure a greater degree of availability of critically needed items of the Intravenous fluids.

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Study on the Application of Retrograde Intravenous Regional Anesthesia in Claw Lamed Cows (발굽 천행우에서 회귀성 국부 정맥무취위 활용에 관한 연구)

  • 정순욱
    • Journal of Veterinary Clinics
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    • v.15 no.1
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    • pp.56-61
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    • 1998
  • A retrograde intravenous regional anesthesia was applied to the extremities of 30 cows, which was showed that mean value of induction time was 13.5 seconds, duration time 74.4 minutes, frequency of injection until to keep needle into the vein 1.27, and didn't observed local and systemic complications. Under the retrograde intravenous regional anesthesia, it was possible for surgical treatment of 20 cows with various foot disorders, to resect soft tissues of extremities and claw horns, to sexarticulate 2nd phalanx without pain reactions.

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Therapeutic Outcomes and Prognostic Factors in Guillain-Barre Syndrome Treated with Intravenous Immunoglobulin (정주 면역글로불린을 투여 받은 길랑-바레 증후군 환자에서 치료효과와 예후에 영향을 주는 인자들에 관한 연구)

  • Lee, Jee-Young;Cho, Joong-Yang;Kim, Sung Hun;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.6 no.2
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    • pp.92-97
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    • 2004
  • Background: There were several studies comparing prognostic factors in Guillain-Barre syndrome treated with intravenous immunoglobulin and plasmapheresis. However, there were controversies in what were significant factors and there were few studies so far comparing the therapeutic outcomes in patients treated with immunoglobulin. This study was aimed to determine the prognostic factors which affected the therapeutic outcome of Guillain-Barre syndrome treated with intravenous immunoglobulin. Method: We retrospectively reviewed the medical records of patients with Guillain-Barre syndrome admitted to our hospital between January 1999 and March 2004. All patients were treated with intravenous immunoglobulin. Outcome and prognosis were followed up after four weeks using the overall disability sum score. Results: Thirty-six patients were enrolled in this study. According to the clinical and electrophysiological findings, 17 patients were AIDP, 10 were axonal forms, two were mixed and seven had electrophysiologically no evidence of abnormalities. At a follow-up of four weeks, disabilities at the nadir (p<0.001) and admission (P<0.012), initial manifestations of bulbar symptom (P<0.024) and electrodiagnostic features (P<0.013) were significantly correlated with outcome in patients treated with intravenous immunoglobulin. But only disabilities at the nadir (P<0.033) and electrodiagnostic features (P<0.018) were significant in the multivariate logistic regression analysis. Conclusion: Among the patient treated with intravenous immunoglobulin, the outcomes were significantly different according to the neurological status at the nadir. Therefore early diagnosis, administration of intravenous immunoglobulin and preventing complications during acute stages are essential to minimize neurological deficit and shorten the periods of recovery.

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Impact of Intravenous Omega-3-Enriched Lipid Emulsion on Liver Enzyme and Triglyceride Serum Levels of Children Undergoing Gastrointestinal Surgery

  • Hanindita, Meta Herdiana;Widjaja, Nur Aisiyah;Irawan, Roedi;Hidayat, Boerhan;Hariastawa, IGB Adria
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.98-104
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    • 2020
  • Purpose: To investigate the impact of omega-3-enriched lipid emulsion (LE) on liver enzyme (aspartate transaminase [AST] and alanine aminotransferase [ALT]) and triglyceride (TG) levels of children undergoing gastrointestinal surgery. Methods: This experimental randomized controlled group pretest-posttest design study included 14 children who underwent gastrointestinal surgery due to duodenal atresia, jejunal atresia, esophageal atresia, and need for parenteral nutrition for a minimum of 3 days at RSUD Dr. Soetomo Surabaya between August 2018 and January 2019. These children were divided into two groups, those who received standard intravenous LE (medium-chain triglyceride [MCT]/long-chain triglyceride [LCT]) and those who received intravenous omega-3-enriched LE. Differences in AST, ALT, and TG levels were measured before surgery and 3 days after the administration of parenteral nutrition. Results: Liver enzyme and TG levels in each group did not differ significantly before versus 3 days after surgery. However, TG levels were significantly lower in the omega-3-enriched intravenous LE group (p=0.041) at 3 days after surgery, and statistically significant difference in changes in TG levels was noted at 3 days after surgery between MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group (p=0.008). Conclusion: The intravenous omega-3-enriched LE had a better TG-lowering effect than the MCT/LCT intravenous LE in children undergoing gastrointestinal surgery.

The Current Status of Intravenous Infusion Therapy Education for New Nurses and Their Needs for the Education (신규간호사의 정맥주입요법 교육 현황과 교육요구도 분석)

  • Yun, Ju Hee;Seo, Minjeong
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.59-74
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    • 2020
  • Purpose: The purpose of this study is to investigate new nurses' needs for intravenous infusion therapy training by analyzing the current training status. Methods: This study examined the needs for intravenous infusion therapy training with 159 new nurses. The measurement tool consisted of 93 items developed based on intravenous therapy-related studies, and was evaluated on a 4-point Likert scale. For data analysis, SPSS/WIN 25.0 was used, and frequency, percentage, average, standard deviation, paired t-test, were performed. Results: The demand for intravenous therapy education was analyzed using a questionnaire composed of 8 areas, 16 sub-areas, and 93 items. According to the findings, post-ward placement intravenous therapy education(83.7%) is conducted more often than in preliminary education (72.2%). The demand for intravenous infusion therapy education did not differ significantly in preliminary and post-ward placement education (t=-.89, p=.376). While therapy skills were preferred in preliminary education, there were high demands for education content related to blood transfusion, central venous catheter, and drug use in continuing education. As for preferred teaching methods, lecture (38.2%) and simulation (26.7%) were most answered for preliminary education, while a range of methods were preferred for continuing education including lecture (31.1%), clinical practice (20.6%), preceptor training (19.8%), simulation (16.8%), and self-study (11.6%). Conclusion: For efficient training, it is required to provide different education contents and methods for each stage.

Design and Error Verification of Intravenous Injection Detection System that Combines Load Cell and Gyro Sensor (로드셀과 자이로센서를 융합한 수액 감지 시스템 설계 및 오차 검증)

  • Kim, Seon-Chil
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.127-132
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    • 2021
  • The intravenous injection monitoring system used by medical institutions was developed to remotely provide patients with the amount of intravenous injected and the termination point of the injection. In order to measure the amount of intravenous injection input, the weight or flow rate of the level going out from the inside to outside of the intravenous injection can be observed with a measuring sensor. The criteria for devices that apply herein are accuracy and vigilance. In addition, it is compact and should be easy to use when installing intravenous injection on patients. In medical institutions, the accuracy of the measured values must be high, and economically inexpensive devices are required. In this study, low-cost small-weight-centered load cell sensors were applied, and algorithms were applied to reduce the artefact by external movement by converging with gyro sensors for accuracy of measurements. As a result, it was possible to reduce the error of measurement, thereby improving the accuracy of the intravenous injection monitoring measurement value.

Intravenous Regional Administration of Prostaglandin E1 for the Treatment of Buerger's Disease (Buerger법 치료를 위한 국소 정맥내 Prostaglandin E1 주입)

  • Choe, Huhn;Kim, Dong-Chan;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.85-88
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    • 1992
  • Buerger's disease is a chronic occlusive arterial disease in which a non-arteriosclerotic lesion involves medium-sized arteries, veins, and nerves of the distal leg or arm. Sympathetic interruption is indicated to improve blood flow to the involved extremity, although sympathetic blockade can provide temporally relief of vasospasm and pain. Chemical or surgical sympathectomy has been performed for this purpose and intravenous regional sympathetic block(IRSB) is an alternative. Guanethidine or reserpine has been administered for IRSB. Intraarterial or intravenous systemic administration of prostaglandin E1(PGE1) has been recommended for the treatment of Buerger's disease. We used PGE1 for intravenous regional administration as an IRSB with results as good as that of intraarterial injection. The advantages of the method include that it is less expensive than systemic administration, less invasive than intra-arterial injection, and simple in technical application.

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Mammary and renal excretion of sulphamethomidine in cows (Sulphamethomidine의 젖소에 있어서의 유선과 신장을 통한 배출)

  • Lee, Jang-nag;Kjaersgaard, Per
    • Korean Journal of Veterinary Research
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    • v.7 no.2
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    • pp.51-55
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    • 1967
  • The mammary excretion of suphamethomidine after intravenous and/or oral administration was investigated in cow. The results show that sulphamethomidine is bound to plasma proteins to a great extent (80~90%). Ay a dosage of 60 mg./kg. maximal concenration in plasma of this sulphonamide was reached 7-10 hours after oral dosing. The sulphonamide concentration in plasma slowly declined after both oral and intravenous administration (fig. 1, 2, and 3) The concentration of sulphonamide in milk was very low and the excretion was completed in 7 days after a single oral dose and 5 days after intravenous injection while in the case of blood plasma it was 11 and 7 days, respectively. In addition, the renal excretion of sulphamethomidine was investigated while under continuous intravenous intravenous infusion. The excretion ratios varies according to self depression (table. 1). Blockade of the tubular secretion with diodone lowered the excretion of sulphamethomidine. It is concluded that the renal excretion of sulphamethomidine in cows occurs by filtration by slight tubular secretion and also by a high rate of back diffusion.

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Current trends in intravenous sedative drugs for dental procedures

  • Yoon, Ji-Young;Kim, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.2
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    • pp.89-94
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    • 2016
  • Anxiety and phobia in dental procedures are common deterrents for patients visiting the dental care unit. For these individuals, procedural sedation may aid in completion of dental treatments. In most cases, the patients are conscious during sedation, thereby allowing spontaneous ventilation. Intravenous sedation (IVS) is widely used during dental treatment to relieve patient anxiety. IVS is the most effective route of administration to achieve this goal, but it requires advanced training, more than that provided during undergraduate education. During IVS, rapid onset, repetitive drug administration, easy titration, and rapid recovery from sedation can be achieved. However, conscious sedation during IVS can result in deep sedation that can cause respiratory and cardiovascular depression. Therefore, the characteristics of intravenous sedatives should be known. The purpose of this review is to discuss the characteristics and usage of intravenous sedatives currently used for dental procedures.